Ultrasonic assembly for use with ultrasonic surgical instruments

ABSTRACT

A surgical instrument includes an ultrasonic transducer assembly comprising a coupling portion laterally movable at an ultrasonic frequency. In addition, the surgical instrument includes an ultrasonic transmission waveguide extending from the coupling portion and an ultrasonic treatment element defining a cutting surface, wherein the ultrasonic treatment element extends from the ultrasonic transmission waveguide, and wherein the lateral movement of the coupling portion is in a direction perpendicular to a plane defined by the cutting surface of the ultrasonic treatment element.

BACKGROUND

The present disclosure relates to surgical instruments and, in various embodiments, to ultrasonic surgical instruments.

Ultrasonic surgical instruments are used in many applications in surgical procedures by virtue of their unique performance characteristics. In various instances, ultrasonic surgical instruments can be configured for use in open, laparoscopic, or endoscopic surgical procedures. Ultrasonic surgical instruments can also be configured for use in robotic-assisted surgical procedures.

FIGURES

The features of the various embodiments are set forth with particularity in the appended claims. The various embodiments, however, both as to organization and methods of operation, together with advantages thereof, may best be understood by reference to the following description, taken in conjunction with the accompanying drawings as follows:

FIG. 1 is a side view of an ultrasonic surgical instrument in accordance with at least one aspect of the present disclosure;

FIG. 2 is a perspective view of an ultrasonic assembly in accordance with at least one aspect of the present disclosure;

FIG. 3 is a side elevational view of the ultrasonic assembly of FIG. 2;

FIG. 4 is a front view of the ultrasonic assembly of FIG. 2;

FIG. 5 illustrates four stages of a reciprocating motion generated by a transducer assembly of the ultrasonic assembly of FIG. 2;

FIGS. 6-13 illustrate a full range of motion of the ultrasonic assembly of FIG. 2;

FIG. 14 is a side view of an ultrasonic assembly in accordance with at least one aspect of the present disclosure;

FIG. 14A is a side view of an ultrasonic assembly in accordance with at least one aspect of the present disclosure; and

FIG. 15 illustrates a treatment element of the ultrasonic assembly of FIG. 14 in torsional motion.

DESCRIPTION

Numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments as described in the specification and illustrated in the accompanying drawings. Well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described in the specification. The reader will understand that the embodiments described and illustrated herein are non-limiting examples, and thus it can be appreciated that the specific structural and functional details disclosed herein may be representative and illustrative. Variations and changes thereto may be made without departing from the scope of the claims.

The terms “comprise” (and any form of comprise, such as “comprises” and “comprising”), “have” (and any form of have, such as “has” and “having”), “include” (and any form of include, such as “includes” and “including”) and “contain” (and any form of contain, such as “contains” and “containing”) are open-ended linking verbs. As a result, a surgical system, device, or apparatus that “comprises,” “has,” “includes” or “contains” one or more elements possesses those one or more elements, but is not limited to possessing only those one or more elements. Likewise, an element of a system, device, or apparatus that “comprises,” “has,” “includes” or “contains” one or more features possesses those one or more features, but is not limited to possessing only those one or more features.

The terms “proximal” and “distal” are used herein with reference to a clinician manipulating the handle portion of the surgical instrument. The term “proximal” referring to the portion closest to the clinician and the term “distal” referring to the portion located away from the clinician. It will be further appreciated that, for convenience and clarity, spatial terms such as “vertical”, “horizontal”, “up”, and “down” may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present Detailed Description proceeds, the reader will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working channel through which the end effector and elongated shaft of a surgical instrument can be advanced.

FIG. 1 illustrates a right side view of one embodiment of an ultrasonic surgical instrument 110 suitably operable with an ultrasonic assembly such as, for example, an ultrasonic assembly 10 (see FIG. 2) and/or an ultrasonic assembly 10′ (see FIG. 14). In one aspect, the ultrasonic surgical instrument 110 comprises a handle assembly 112 extending proximally from an elongate shaft assembly 114, and an end effector assembly 126 extending distally from the elongate shaft assembly 114. An ultrasonic transmission waveguide may extend, or at least partially extend, through the elongate shaft assembly 114. A distal end portion of the ultrasonic transmission waveguide can be acoustically coupled (e.g., directly or indirectly mechanically coupled) to a treatment element 165. A proximal end portion of the ultrasonic transmission waveguide may include a horn. A coupling portion may extend proximally from the horn. The coupling portion can be received within the handle assembly 112 for acoustic coupling to an ultrasonic transducer 16.

The handle assembly 112 comprises a trigger 132, a handle 133, a distal rotation assembly 113, and a switch assembly 128. The elongated shaft assembly 114 comprises an end effector assembly 126 and actuating elements to actuate the end effector assembly 126. The handle assembly 112 is adapted to receive the ultrasonic transducer 16 at the proximal end. The ultrasonic transducer 16 can be mechanically engaged to the elongated shaft assembly 114 and portions of the end effector assembly 126. The ultrasonic transducer 16 can be electrically coupled to a generator 120 via a cable 122. In certain instances, the generator 120 can be integrated with the handle assembly 112, for example. A suitable generator is available as model number GEN11, from Ethicon Endo-Surgery, Inc., Cincinnati, Ohio.

The ultrasonic transducer 16 may convert the electrical signal from the ultrasonic signal generator 120 into mechanical energy that results in primarily a standing acoustic wave of transverse vibratory motion of the ultrasonic transducer 16 and the treatment element 14 at ultrasonic frequencies.

In various instances, the energy generated in the treatment element 14 can be employed to cut and/or coagulate tissue. In one embodiment, vibrating at high frequencies (e.g., 55,500 times per second), the treatment element 14 may denature protein in a treated tissue to form a coagulum.

Although FIG. 1 depicts an end effector assembly 126 for use in connection with laparoscopic surgical procedures, the ultrasonic assembly 10 can be assembled with other ultrasonic surgical instruments that may be employed in more traditional open surgical procedures and in other embodiments, may be configured for use in endoscopic procedures.

In various embodiments, the generator 120 comprises several functional elements, such as modules and/or blocks. Different functional elements or modules may be configured for driving different kinds of surgical devices. For example, an ultrasonic generator module 121 may drive an ultrasonic device, such as the ultrasonic surgical instrument 110. In some example embodiments, the generator 120 also comprises an electrosurgery/RF generator module 123 for driving an electrosurgical device. In the example embodiment illustrated in FIG. 1, the generator 120 includes a control system 125. When activated by the control system 125, the generator 120 may provide energy to drive a treatment element of the ultrasonic surgical instrument 110.

Referring again to FIG. 1, the elongated shaft assembly 114 comprises a proximal end portion 150 adapted to mechanically engage the handle assembly 112 and the distal rotation assembly 113, and a distal end portion 152 adapted to mechanically engage the end effector assembly 126. The elongated shaft assembly 114 comprises an outer tubular sheath 156 and an actuating member located within the outer tubular sheath 156. The actuating member can be mechanically engaged to the trigger 132 of the handle assembly 112 to move in response to the actuation and/or release of the trigger 132. The pivotably moveable trigger 132 may generate reciprocating motion to actuate an end effector 118 of the end effector assembly 126.

A distal portion of the actuating member is mechanically engaged to the end effector 118 to actuate a clamp member 164, for example, which is pivotable about a pivot point 170, to open and close the clamp member 164 in response to the actuation and/or release of the trigger 132. To open the clamp member 164, the clamp member 164 is moved away from a treatment element 165. On the other hand, to close the clamp member 164, the clamp member 164 is moved toward the treatment element 165. Tissue can be captured between the clamp member 164 and the treatment element 165 in a closed configuration.

Referring generally to FIGS. 2-4, an ultrasonic assembly 10 is depicted. The ultrasonic assembly 10 includes an ultrasonic transmission bar 11 including a coupling portion 15, a horn 13, an ultrasonic transmission waveguide 12, and a treatment element 14. The coupling portion 15 extends proximally from the horn 13 for acoustic coupling to piezoelectric elements 32 and 32′. In addition, the treatment element 14 is configured to be acoustically coupled (e.g., directly or indirectly mechanically coupled) to the ultrasonic transmission waveguide 12.

The treatment element 14 comprises a body 18 that generally protrudes, or extends, from the ultrasonic transmission waveguide 12 in a distal direction terminating in a blunt, or at least substantially blunt, tip 20. The body 18 generally includes a first side 22 and a second side 24 opposite, or at least substantially opposite, the first side 22. The blunt tip 20 can be fine but sufficiently atraumatic to allow for improved otomty creation and separation of tissue planes. As illustrated in FIG. 2, the sides 22 and 24 comprise triangular, or at least substantially triangular, shapes that form, or at least substantially form, a flat arrow-head shaped treatment element 14. Other treatment elements are contemplated by the present disclosure such as a hook shaped treatment element, for example. The sides 22 and 24 cooperate to define outer edges 28 and 30 of the body 18 that intersect at the tip 20.

A securing feature 41 is provided at a vibration node of the ultrasonic assembly 10. A vibration node is a point of substantially zero displacement. As illustrated in FIG. 2, the securing feature 41 is positioned between the horn 13 and the waveguide 12. Other positions of the securing feature 41 are contemplated by the present disclosure. Positioning the securing feature 41 at a vibration node facilitates attachment of the securing member 41 to an external housing. An aperture 43 of the securing feature 41 may be configured to receive an attachment member of the external housing to secure the ultrasonic assembly 10 to the external housing.

The ultrasonic assembly 10 may further include a tuning region 46 disposed at a proximal portion of the ultrasonic assembly 10. The tuning region 46 can be configured to balance the ultrasonic assembly 10 so that, in operation, the ultrasonic assembly 10 produces a standing wave with a vibration antinode at the treatment element 14. A vibration antinode is a point of maximum displacement relative to all other points in a half wave. In at least one aspect, the tuning region 46 is positioned at a proximal end of the coupling portion 15. The ultrasonic assembly 10 can be tuned by grinding or shaving the tuning region 46 to reduce its mass until a desired standing wave is achieved.

The ultrasonic assembly 10 further includes a transducer assembly 17 that comprises two piezoelectric elements 32 and 32′ in the form of plates positioned on opposite sides of the coupling portion 15. In at least one aspect, the plates are comprised of a circular shape. In other embodiments, the PZT elements may comprise other shapes such as, for example, square or rectangular prisms. Other shapes are contemplated by this disclosure. The coupling portion 15 is captured between the piezoelectric elements 32 and 32′, as illustrated in FIG. 2. In at least one aspect, the piezoelectric elements 32 and 32′ are comprised of a piezoelectric ceramic material. In at least one aspect, the material(s) of the piezoelectric elements 32 and 32′ may have an electromechanical coupling coefficient K31 of at least 0.3, for example. The resonant frequency of the piezoelectric elements 32 and 32′ depends on the piezoelectric material and the dimension of the piezoelectric elements in the direction of the vibration.

The piezoelectric elements 32 and 32′ and end masses 34 are held in compression against electrode tabs 31. The electrode tabs 31 are held in compression with the coupling portion 15 using securing members in the form of washers 36 and bolts 38, as illustrated in FIG. 2. Collectively, the bolt 38, washers 36, end masses 34, electrode tabs 31, and piezoelectric elements 34 and 34′ are generically referred to as the piezoelectric stack. A compressive preload created by torqueing the bolt is used to prevent brittle facture of the piezoelectric elements 34, 34′ when exposed to alternating high electric field because it reduces their exposure to tensile stresses. The masses 34 are positioned on opposite sides of the coupling portion 15. In the embodiment illustrated in FIG. 2, each of the piezoelectric elements 32 and 32′ is tightly placed between one of the electrode tabs 31 which is in intimate contact with the end masses 34 and one of the sides of the coupling portion 15. The electrode tabs 31 are used to apply an electrical field to piezoelectric element 32 and 32′, resulting in the desired expansion or contraction of the element. Other arrangements of the masses 34 and the piezoelectric elements 32 and 32′ are contemplated by the present disclosure. Furthermore, other securing members can be employed to hold the masses 34 and the piezoelectric elements 32 and 32′ in place around the coupling portion 15. In addition, the transducer assembly 17 may include more or less than two piezoelectric elements 32 and 32′ and two masses 34.

Referring to FIGS. 3-5, the transducer assembly 17 is configured to cause the treatment element 14 to vibrate in a reciprocating motion that traverses a longitudinal axis 48 extending along the X-axis. As illustrated in FIG. 3, the longitudinal axis 48 extends along the ultrasonic transmission bar 11 and through the tip 20 of the treatment element 14. In operation, as illustrated in FIGS. 4 and 5, the treatment element 14 is configured to vibrate laterally at ultrasonic frequencies about the Y-Z plane that is defined along the edges 28 and 30 of the treatment element 14 in an inactive state, for example. An inactive state is a state where no energy is delivered to the piezoelectric elements 32 and 32′.

Referring primarily to FIG. 5, basic stages of the reciprocating motion generated by the transducer assembly 17 are depicted. In a neutral or first stage, the piezoelectric elements 32 and 32′ are inactive and, accordingly, the treatment element 14 is at a central position of its range of motion. In a second stage, the piezoelectric element 32 is expanded while the piezoelectric element 32′ is contracted causing the coupling portion 15 to move laterally toward the contracting piezoelectric element 32′. In a third stage, the piezoelectric elements 32 and 32′ return to their native states repositioning the coupling portion 15 at the central position of its range of motion. Finally, at a fourth stage, the piezoelectric element 32′ is expanded while the piezoelectric element 32 is contracted causing the coupling portion 15 to move laterally toward the contracting piezoelectric element 32. The first through fourth stages are then repeated causing the coupling portion 15 to vibrate at ultrasonic frequencies.

Ultrasonic vibrations of the coupling portion 15 are transmitted to the treatment element 14 through the horn 13 and the ultrasonic transmission waveguide 12 yielding a standing acoustic wave of transverse vibratory motion. FIGS. 6-13 illustrate the full range of motion of an ultrasonic assembly 10. A tip 20 of a treatment element 14 may laterally reciprocate between a first position (see FIG. 6) on a first side of a plane defined by the coupling portion 15 to a second position (see FIG. 13) on a second side, opposite the first side, of the plane defined by the coupling portion 15. The tip 20 passes through a neutral or central position as the tip 20 transitions from the first position to the second position. The neutral position is defined by the tip 20 in an inactive state, as illustrated in FIG. 4.

In the embodiment illustrated in FIGS. 6-13, the tip 20 defines an antinode in operation. Accordingly, the first and second positions define points of maximum displacement in the range of motion of the tip 20. The reciprocation of the tip 20 between the first position, depicted in FIG. 6, and the second position, depicted in FIG. 13, permits the tip 20 to apply a shearing motion to tissue in contact with the tip 20. As illustrated in FIGS. 6-13, the reciprocation motion of the treatment element 14 is perpendicular to a cutting surface defined by the outer edges 28 and 30 of the body 18. The reciprocation motion of the outer edges 28 and 30 permits the outer edges 28 and 30 to apply a shearing motion to tissue in contact with the outer edges 28 and 30. This design provides good tissue transection while minimizing bleeding.

In certain instances, an ultrasonic assembly 10 may include a treatment element 14 that vibrates at ultrasonic frequencies by moving toward first and second parallel, or at least substantially parallel, planes. The first and second planes are defined, in an inactive state, by outer surfaces of the piezoelectric elements 32, 32′, respectively, that are pressed against the masses 34.

In certain instances, the ultrasonic transmission waveguide 12 is symmetrical about the longitudinal axis 48, as illustrated in FIG. 3. In such instances, the transducer assembly 17 propagates shear waves which bend into and out of the X-Y plane. In other words, the treatment element 14 reciprocates into and out of the X-Y plane.

In other instances, as illustrated in FIG. 14, an ultrasonic assembly 10′, which is similar in many respects to the ultrasonic assembly 10, can be equipped with an asymmetrical ultrasonic transmission waveguide 12′ to convert the shear or lateral reciprocation motion of the treatment element 14 into a torsional motion while the transducer assembly 17 continues to propagate shear waves. In other words, the reciprocation of the transducer assembly 17 of the ultrasonic assembly 10′ about the X-Y plane causes the treatment element 14 to move about the X-Z plane in addition to moving about the Y-Z plane. The resulting movement of the treatment element 14 is a torsional motion, as depicted in FIG. 15.

An asymmetrical ultrasonic transmission waveguide 12′ can be created shifting the centroid of a symmetrical ultrasonic transmission waveguide. In at least one instance, an asymmetrical ultrasonic transmission waveguide 12′ can be created by removing material from or adding material to a symmetrical ultrasonic transmission waveguide 12, for example. As illustrated in FIG. 14, the ultrasonic transmission waveguide 12′ of the ultrasonic assembly 10′ includes a balance groove, indentation, or notch 50 configured to cause an asymmetry between a first portion 12 a and a second portion 12 b of the ultrasonic transmission waveguide 12′ about the longitudinal axis 48. In the inactive state, the first portion 12 a is positioned on a first side of a plane perpendicular, or at least substantially perpendicular, to the coupling portion 15 and intersecting the longitudinal axis 48. The portion 12 b is positioned on a second side of the plane opposite the first side.

The balance notch 50 is configured to reduce the mass of the first portion 12 a. In certain instances, the first portion 12 a comprises a first mass smaller than a second mass of the second portion 12 b. Alternatively, the first portion 12 a may comprise a first mass greater than a second mass of the second portion 12 b. In certain instances, an ultrasonic transmission waveguide 12′ may include more than one balance notch 50.

Referring to FIG. 14A, an ultrasonic assembly 10″, which is similar in many respects to the ultrasonic assemblies 10 and 10′, can be equipped with an asymmetrical ultrasonic transmission waveguide 12″ to convert the shear or lateral reciprocation motion of the treatment element 14 into a torsional motion while the transducer assembly 17 continues to propagate shear waves. An asymmetrical ultrasonic transmission waveguide 12″ can be created shifting the centroid of a symmetrical ultrasonic transmission waveguide. In at least one instance, an asymmetrical ultrasonic transmission waveguide 12″ can be created by adding material to a symmetrical ultrasonic transmission waveguide 12, for example. As illustrated in FIG. 14, the ultrasonic transmission waveguide 12″ of the ultrasonic assembly 10″ includes a balance projection, protrusion, lump, or bump 51 configured to cause an asymmetry between a first portion 12 a and a second portion 12 b of the ultrasonic transmission waveguide 12″ about the longitudinal axis 48. In the inactive state, the first portion 12 a is positioned on a first side of a plane perpendicular, or at least substantially perpendicular, to the coupling portion 15 and intersecting the longitudinal axis 48. The portion 12 b is positioned on a second side of the plane opposite the first side. The balance lump 51 is configured to increase the mass of the first portion 12 a. In certain instances, the first portion 12 a comprises a first mass greater than a second mass of the second portion 12 b. Alternatively, the first portion 12 a may comprise a first mass smaller than a second mass of the second portion 12 b.

In certain instances, an ultrasonic transmission waveguide 12″ may include one or more balance notches 50 and one or more balance lumps 51, for example. In at least one instance, one or more balance notches 50 and/or balance lumps 51 are position at a distal portion of an ultrasonic transmission waveguide. The balance notches 50 and/or balance lumps 51 can be manufactured with an ultrasonic transmission waveguide or added post-manufacturing. In certain instances, a notch lump 51 can be attached to an ultrasonic transmission waveguide by screws, welding techniques, or other suitable techniques.

Referring to FIG. 15, the treatment element 14 experiences an angular motion caused by the asymmetry in the ultrasonic transmission waveguide 12′. In at least one instance, the treatment element 14 is configured to rotate at an angle selected from a range of about 5° to about 35° as the transducer assembly 17 propagates shear waves. In at least one instance, the treatment element 14 is configured to rotate at an angle selected from a range of about 10° to about 30° as the transducer assembly 17 propagates shear waves. In at least one instance, the treatment element 14 is configured to rotate at an angle selected from a range of about 15° to about 25° as the transducer assembly 17 propagates shear waves. In at least one instance, the treatment element 14 is configured to rotate at an angle of about 20° while the transducer assembly 17 propagates shear waves, as illustrated in FIG. 15.

In certain instances, rather than creating an imbalance by modifying a symmetrical ultrasonic transmission waveguide, an imbalance can be created by modifying a symmetrical treatment element 14. In other words, an ultrasonic assembly 10′ can be designed or modified to include a symmetrical ultrasonic transmission waveguide and an asymmetrical treatment element which moves torsionally in response to shear waves propagated by an transducer assembly 17 of the ultrasonic assembly 10′. In certain instances, an ultrasonic assembly 10′ can be designed or modified to include an asymmetrical ultrasonic transmission waveguide and an asymmetrical treatment element, for example.

Like an asymmetrical ultrasonic transmission waveguide an asymmetrical treatment element can be created by shifting the centroid of a symmetrical treatment element 14. In at least one instance, an asymmetrical treatment element can be created by removing material from or adding material to a symmetrical treatment element 14, for example. In at least one instance, the centroid of a treatment element 14 of an ultrasonic assembly 10′ can be shifted or moved along the Y-axis relative to the centroid of a corresponding ultrasonic transmission waveguide. Notably, in a balanced ultrasonic assembly 10, the centroid of the ultrasonic transmission waveguide 12 can be on the longitudinal axis 48. In at least one instance, an asymmetrical treatment element comprising at least one curvature can be employed with the ultrasonic assembly 10′ in place of the symmetrical treatment element 14.

The entire disclosures of:

U.S. patent application Ser. No. 14/448,430, titled ACTUATION MECHANISMS AND LOAD ADJUSTMENT ASSEMBLIES FOR SURGICAL INSTRUMENTS, filed Jul. 31, 2014; and

U.S. Patent Publication No. 2014/0005704 A1, titled ULTRASONIC SURGICAL INSTRUMENTS WITH DISTALLY POSITIONED JAW ASSEMBLIES, filed Jun. 29, 2012, are hereby incorporated by reference herein.

EXAMPLES Example 1

A surgical instrument comprising an ultrasonic transducer assembly comprising a coupling portion laterally movable at an ultrasonic frequency, an ultrasonic transmission waveguide extending from the coupling portion, and an ultrasonic treatment element defining a cutting surface, wherein the ultrasonic treatment element extends from the ultrasonic transmission waveguide, and wherein the lateral movement of the coupling portion is in a direction perpendicular to a plane defined by the cutting surface of the ultrasonic treatment element.

Example 2

The surgical instrument of Example 1, wherein the lateral movement of the coupling portion is configured to cause the ultrasonic treatment element to vibrate at an ultrasonic frequency.

Example 3

The surgical instrument of Examples 1 or 2, wherein the ultrasonic transducer assembly comprises at least one piezoelectric element.

Example 4

The surgical instrument of Examples 1, 2, or 3, wherein the ultrasonic transducer assembly comprises two piezoelectric elements, and wherein the coupling portion is positioned between the two piezoelectric elements.

Example 5

The surgical instrument of Example 4, wherein the ultrasonic transducer assembly comprises two masses laterally external to the two piezoelectric elements.

Example 6

The surgical instrument of Examples 4 or 5, wherein the ultrasonic transducer assembly comprises at least one securing member configured to hold the two piezoelectric elements in contact with the coupling portion.

Example 7

The surgical instrument of Examples 1, 2, 3, 4, 5, or 6, wherein the ultrasonic transmission waveguide is an asymmetric ultrasonic transmission waveguide.

Example 8

The surgical instrument of Examples 1, 2, 3, 4, 5, 6, or 7, wherein the ultrasonic transmission waveguide comprises at least one notch.

Example 9

The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, or 8, wherein the ultrasonic transducer assembly comprises a tuning feature.

Example 10

A surgical instrument comprising an ultrasonic transducer assembly comprising a coupling portion, an ultrasonic transmission waveguide extending from the coupling portion, wherein the ultrasonic transmission waveguide defines a longitudinal axis, and an ultrasonic treatment element comprising a distal tip, wherein the ultrasonic treatment element extends from the ultrasonic transmission waveguide, wherein the longitudinal axis extends through the distal tip, and wherein the coupling portion is configured to reciprocate laterally with respect to the longitudinal axis at an ultrasonic frequency.

Example 11

The surgical instrument of Example 10, wherein the reciprocal lateral movement of the coupling portion is configured to cause the ultrasonic treatment element to vibrate at an ultrasonic frequency.

Example 12

The surgical instrument of Examples 10 or 11, wherein the ultrasonic transducer assembly comprises at least one piezoelectric element.

Example 13

The surgical instrument of Examples 10, 11, or 12, wherein the ultrasonic transducer assembly comprises two piezoelectric elements, and wherein the coupling portion is positioned between the two piezoelectric elements.

Example 14

The surgical instrument of Example 13, wherein the ultrasonic transducer assembly comprises two masses laterally external to the two piezoelectric elements.

Example 15

The surgical instrument of Examples 13 or 14, wherein the ultrasonic transducer assembly comprises at least one securing member configured to hold the two piezoelectric elements in contact with the coupling portion.

Example 16

The surgical instrument of Examples 10, 11, 12, 13, 14, or 15, wherein the ultrasonic transmission waveguide is an asymmetric ultrasonic transmission waveguide.

Example 17

The surgical instrument of Examples 10, 11, 12, 13, 14, 15, or 16, wherein the ultrasonic transmission waveguide comprises at least one notch.

Example 18

The surgical instrument of Examples 10, 11, 12, 13, 14, 15, 16, or 17, wherein the ultrasonic transducer assembly comprises a tuning feature.

Example 19

The surgical instrument of Example 18, wherein the tuning feature comprises at least one projection.

Example 20

A surgical instrument comprising an ultrasonic transducer assembly comprising a coupling portion laterally movable at an ultrasonic frequency, an asymmetric ultrasonic transmission waveguide extending from the coupling portion, and an ultrasonic treatment element defining a cutting surface, wherein the ultrasonic treatment element extends from the asymmetric ultrasonic transmission waveguide, and wherein the lateral movement of the coupling portion causes a torsional reciprocating motion of the ultrasonic treatment element.

Example 21

The surgical instrument of Example 20, wherein the asymmetric ultrasonic transmission waveguide comprises at least one notch.

Example 22

The surgical instrument of Examples 20 or 21, wherein the asymmetric ultrasonic transmission waveguide comprises at least one projection.

Although the various embodiments of the devices have been described herein in connection with certain disclosed embodiments, many modifications and variations to those embodiments may be implemented. Also, where materials are disclosed for certain components, other materials may be used. Furthermore, according to various embodiments, a single component may be replaced by multiple components, and multiple components may be replaced by a single component, to perform a given function or functions. The foregoing description and following claims are intended to cover all such modification and variations.

The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.

By way of example only, aspects described herein may be processed before surgery. First, a new or used instrument may be obtained and when necessary, cleaned. The instrument may then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the instrument and in the container. The sterilized instrument may then be stored in the sterile container. The sealed container may keep the instrument sterile until it is opened in a medical facility. A device also may be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, plasma peroxide, or steam.

While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles.

Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material. 

What is claimed is:
 1. A surgical instrument, comprising: a longitudinal axis; and an ultrasonic transducer assembly, comprising: a coupling portion configured to vibrate laterally at an ultrasonic frequency in a direction perpendicular to the longitudinal axis; at least two piezoelectric elements positioned on opposite sides of the coupling portion, wherein the at least two piezoelectric elements are configured to vibrate laterally in a direction perpendicular to the longitudinal axis; and at least one securing member extending at least partially through the coupling portion and the at least two piezoelectric elements; an ultrasonic transmission waveguide extending longitudinally from the coupling portion; and an ultrasonic treatment element comprising a plurality of cutting edges defining a cutting surface, wherein the ultrasonic treatment element extends from the ultrasonic transmission waveguide, and wherein the lateral vibration of the at least two piezoelectric elements causes a torsional reciprocating motion of the ultrasonic treatment element.
 2. The surgical instrument of claim 1, wherein the lateral vibration of the coupling portion is configured to cause the ultrasonic treatment element to reciprocate at an ultrasonic frequency.
 3. The surgical instrument of claim 1, wherein the ultrasonic transducer assembly comprises two masses laterally external to the at least two piezoelectric elements.
 4. The surgical instrument of claim 3, wherein the at least one securing member is configured to hold the at least two piezoelectric elements in contact with the coupling portion.
 5. The surgical instrument of claim 1, wherein the ultrasonic transmission waveguide is an asymmetric ultrasonic transmission waveguide.
 6. The surgical instrument of claim 1, wherein the ultrasonic transmission waveguide comprises at least one notch.
 7. The surgical instrument of claim 1, wherein the ultrasonic transducer assembly comprises a tuning feature.
 8. A surgical instrument, comprising: an ultrasonic transducer assembly, comprising: a coupling portion; at least two piezoelectric elements positioned on opposite sides of the coupling portion; and at least one securing member extending at least partially through the coupling portion and the at least two piezoelectric elements; an ultrasonic transmission waveguide extending from the coupling portion, wherein the ultrasonic transmission waveguide defines a longitudinal axis; and an ultrasonic treatment element comprising a distal tip comprising a plurality of cutting edges, wherein the ultrasonic treatment element extends from the ultrasonic transmission waveguide, wherein the longitudinal axis extends through the distal tip, wherein the coupling portion and the at least two piezoelectric elements are configured to reciprocate laterally in a direction perpendicular to the longitudinal axis, and wherein the reciprocation of the piezoelectric elements causes a torsional reciprocating motion of the ultrasonic treatment element.
 9. The surgical instrument of claim 8, wherein the coupling portion is positioned between the at least two piezoelectric elements.
 10. The surgical instrument of claim 8, wherein the ultrasonic transducer assembly comprises two masses laterally external to the at least two piezoelectric elements.
 11. The surgical instrument of claim 10, wherein the at least one securing member is configured to hold the at least two piezoelectric elements in contact with the coupling portion.
 12. The surgical instrument of claim 8, wherein the ultrasonic transmission waveguide is an asymmetric ultrasonic transmission waveguide.
 13. The surgical instrument of claim 8, wherein the ultrasonic transmission waveguide comprises at least one notch.
 14. The surgical instrument of claim 8, wherein the ultrasonic transducer assembly comprises a tuning feature.
 15. The surgical instrument of claim 14, wherein the tuning feature comprises at least one projection.
 16. A surgical instrument, comprising: a longitudinal axis; and an ultrasonic transducer assembly, comprising: a coupling portion configured to vibrate laterally at an ultrasonic frequency; piezoelectric elements positioned on opposite sides of the coupling portion; and a securing member extending at least partially through the coupling portion and the piezoelectric elements; an asymmetric ultrasonic transmission waveguide extending from the coupling portion; and an ultrasonic treatment element comprising a plurality of cutting edges defining a cutting surface, wherein the coupling portion and the piezoelectric elements are configured to vibrate laterally in a direction perpendicular to the longitudinal axis, wherein the ultrasonic treatment element extends longitudinally from the asymmetric ultrasonic transmission waveguide, and wherein the lateral vibration of the coupling portion causes a torsional reciprocating motion of the ultrasonic treatment element.
 17. The surgical instrument of claim 16, wherein the asymmetric ultrasonic transmission waveguide comprises at least one notch.
 18. The surgical instrument of claim 16, wherein the asymmetric ultrasonic transmission waveguide comprises at least one projection. 